Integrating Child Welfare, Juvenile Justice, and Other Agencies in a Continuum of Services

By Howell, James C.; Kelly, Marion R. et al. | Child Welfare, March/April 2004 | Go to article overview

Integrating Child Welfare, Juvenile Justice, and Other Agencies in a Continuum of Services


Howell, James C., Kelly, Marion R., Palmer, James, Mangum, Ronald L., Child Welfare


This article presents a comprehensive strategy framework for integrating mental health, child welfare, education, substance abuse, and juvenile justice system services. It proposes an infrastructure of information exchange, cross-agency client referrals, a networking protocol, interagency councils, and service integration models. This infrastructure facilitates integrated service delivery.

We have a compelling need to integrate mental health, child welfare, education, substance abuse, and juvenile justice system services effectively. The best nationwide data supporting this need for integration are from the National Adolescent and Child Treatment Study (NACTS). NACTS data showed that less than 6% of seriously emotionally disturbed (SED) youth received services from only one system and nearly 4 out of 10 received services from three systems (Greenbaum et al., 1996).

The most commonly accessed service system was mental health (93%), followed by juvenile justice (80%), school-based special education (71%), and child welfare (69%). Follow-up on the sample six years later found that these services were not effective with the SED population. More than 4 out of 10 youth of the total sample had been arrested six years later, and one-third were adjudicated or convicted in criminal court. The youngest children in the sample fared worst. Of youth discharged from a mental health placement, 75% were either readmitted to a mental health placement or committed to a juvenile correctional facility.

NACTS also highlighted the need to integrate substance abuse treatment with services provided in the other systems. A large proportion of youth admitted to detention centers (Teplin, 2001) and juvenile correctional facilities (McGarvey & Waite, 2000) have substance abuse problems. Moreover, substance abuse is interrelated with other adolescent problem behaviors (Huizinga & JakobChien, 1998).

The NACTS study authors (Greenbaum et al., 1996) concluded that short-term interventions targeting a specific problem are not likely to be effective with the SED population and that comprehensive, integrated services delivered for an extended time are needed to achieve positive outcomes. The co-occurrence of multiple child and adolescent problems is another important basis for integrated multisystem initiatives. Youths' problems tend to come bundled together, often stacked on one another over time (Loeber & Farrington, 2001). The need for an integrated response is buttressed by the fact that children and adolescents are often sent haphazardly through the fragmented systems charged with addressing their problems (Armstrong, 1998).

Integration of the necessary services is further complicated by agencies' over-reliance on residential care. Youth can languish in residential care for long periods of time. The residential facilities of the child welfare (Kortenkamp & Ehrle, 2002), mental health (Lerman, 2002), and juvenile justice systems (Howell, 2003) are all overloaded. Ineffective programs are common in youth-serving systems, and failure rates are highest for youth in residential facilities, principally because of the ineffectiveness of bed-driven treatment (Howell, 2003, pp. 130-137; Lerman, 2002).

Organizing and implementing an integrated system of services is further complicated because youth-serving systems "are too crisis-oriented, too rigid in their classification of problems, too specialized, too isolated from other services, too inflexible to craft comprehensive solutions, too insufficiently funded, and they are mismanaged" (Roush, 1996, p. 29). The central question, then, is: How can youth services be structured to optimize the integration of services, improve service delivery, reduce reliance on costly and ineffective residential facilities, and improve outcomes? This article discusses a useful framework for organizing youth services and includes descriptions of infrastructures the framework embraces that can help integrate the entire array of youth-serving systems. …

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